AFP Clinical Answers

Colorectal Cancer Screening, Breastfeeding, Miscarriage, Eczema, Routine Screening for Children


Am Fam Physician. 2020 Mar 1;101(5):270.

Is flexible sigmoidoscopy better than fecal occult blood testing for colorectal cancer screening in adults?

Although both are effective at reducing colorectal cancer mortality, flexible sigmoidoscopy appears to reduce colorectal cancer mortality more than guaiac-based fecal occult blood testing (FOBT). Flexible sigmoidoscopy is not clearly superior because the two methods have not been directly compared. Screening with flexible sigmoidoscopy prevented one death for every 450 asymptomatic adults screened compared with one death prevented for every 900 asymptomatic adults screened with FOBT. Both methods had similar harms of bleeding, perforation, or death related to follow-up colonoscopy or surgery. The number needed to harm was one in 1,250 for flexible sigmoidoscopy and one in 3,300 for FOBT.

Does skin-to-skin-contact in healthy, vigorous newborns improve the duration of breastfeeding in lactating mothers?

Skin-to-skin-contact in the immediate postnatal period should be recommended to all mothers because it is associated with a higher likelihood of exclusive breastfeeding at hospital discharge and for up to six months afterward (number needed to treat = 5 to 8).

What is the advantage of progestin therapy for recurrent miscarriage?

For one-half of women with recurrent spontaneous abortion, defined as three or more miscarriages, no cause can be found. A Cochrane review showed that with early progestin therapy, an additional one in 15 pregnant women did not have a spontaneous abortion, one in 10 went on to have a live birth, and one in 20 avoided preterm labor. Despite these positive outcomes, the studies were limited by heterogeneity and poor control of inclusion criteria. Also, progestin therapy had to be started very early, before many patients would recognize a pregnancy.

Does bath oil improve eczema symptoms in children?

Bath oil does not improve



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